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Biomedical subjects

J Zenk

Publications and source records attributed to J Zenk.

At least 19 recordsLinked to original sources
PubMed2007

[Influence of thyroid cartilage ossification in laryngeal ultrasound].

BACKGROUND: Topological features of the larynx and hypopharynx may be depicted during sonographic examination of the neck, although ultrasound is seen of minor diagnostic importance. The varying extend of thyroid cartilage ossification appears to be the major limiting factor. We intended to assess the sonographic accessability of laryngeal structures with high end resolution ultrasound devices. METHODS AND PATIENTS: We examined 101 patients endoscopically and by ultrasound. Normal laryngeal findings and pathologies were examined and analysed considering limitations by thyroid cartilage ossification. RESULTS: Despite varying grades of ossification, the majority of laryngeal structures were clearly displayed by ultrasound. Ossification was increasing in the elderly. In 16 cases (16 %) ossification prevented a successful evaluation. In 9 cases of malignant tumor and one laryngocele sonographic assessment was able to contribute additional diagnostic information. CONCLUSIONS: Ultrasound of the larynx requires methodical experience of the operator but is capable to depict relevant anatomic structures, even with presence of thyroid cartilage ossification, thus being able to increase diagnostic impact and may save additional imaging modalities.

Adult↗
PubMed2007

[First experiences with a new nickel-titanium piston with a shape memory feature].

BACKGROUND: The aim of this study was to describe a new stapes prosthesis with memory characteristics for wire crimping (SMart-Piston). PATIENTS AND METHODS: This technique was used in 15 patients (mean age 43.4 years; range 28-71) undergoing routine stapes surgery. SMart-Piston prostheses with a shaft diameter of 0.5 mm and length ranging from 4.25-4.5 mm were used. Heat induced wire crimping was performed by CO2 laser in five patients, and by bipolar diathermy forceps in ten patients. In 15 patients, postoperative audiological testing was performed at an average 21.9 days and in another 10 again after 435 days following surgery. RESULTS: The median observed air-bone-gap (ABG) postoperatively was 8.7 dB+/-7.7 dB. A total of 73% of all patients had an ABG of 10 dB or less, and all patients had less than 20 dB. In the ten patients controlled after 435 days, the ABG was 4.4 dB+/-2.4 dB. It was lower than 10 dB in all individuals. DISCUSSION: A critical point in every stapes surgery, the prosthesis fixation to the incus, is greatly facilitated by this novel technique. Long-term results in a larger group of patients are pending.

Adult↗
PubMed2006

[Digital photography and video archives in ENT].

Digital media have become standard documentation tools in modern ENT clinics. To date, multiple formats are generated by variable data sources. Old fashioned archiving techniques with numerous print-outs, hard copies or even slides would soon generate an unmanageable data flood and require costly manpower for proper and precise maintenance. It has become obvious that data archiving is the prime challenge for modern hospital information technology. Multiple computerized multimedia archives exist and offer promising solutions for collecting and managing these data. From a clinical point of view, not only data centralisation but also interactions with existing network components and hospital information technology systems have to be made available. Here, we describe variable data sources and formats, centralisation techniques, networking options and discuss available digital documentation solutions.

Computer Communication Networks↗
PubMed2005

[Submandibular sialoliths. Stone removal with organ preservation].

BACKGROUND: Sialolithiasis as a cause of sialadenitis within Wharton's duct accounts for more than 80% of all cases. In the past extirpation of the gland was carried out in nearly all cases. Gland-preserving therapies such as transoral removal have so far been seldom examined. PATIENTS AND METHODS: In 683 patients suffering from submandibular lithiasis with a mean age of 45 years (8-87 years) transoral removal of the stones were carried out. The follow-up period was 1-7 years. The stone location was distal to the edge of the mylohyoid muscle in 283 cases and more proximal to the gland within the hilum in 296 patients (single concrements). Fifty-nine patients had two separate stones, one within the area of the hilum and other smaller ones proximal within the gland. RESULTS: All patients with distal stone location, 89% of patients with single stones of the perihilar region, and 63% of the patients with two separate stones in the hilum and parenchyma were free of stones. Another 8 and 23%, respectively, had small residual concrements without any complaints. Recurrence of lithiasis or damage of the lingual nerve remained below 1%. CONCLUSION: Transoral removal in palpable sialoliths should be considered as the treatment of choice in patients suffering from submandibular stones located within the floor of the mouth or within the perihilar region of the gland. Ultrasound imaging is important for exact location of the stones.

Adolescent↗
PubMed2005

[HNORAD].

BACKGROUND: New media are gaining importance in undergraduate as well as postgraduate and continued medical education. We aimed to create an interactive educational program for imaging diseases of the ear, nose and throat (ENT). MATERIALS AND METHODS: Cases and images representing clinical routine were collected, arranged by content and graphically presented according to instructional criteria. Undergraduate students participating in the project used an authoring system to generate case studies, which were then published at http://www.HNORAD.de. RESULTS: HNORAD is an interdisciplinary teaching program offering more than 100 classical disease presentations. Three systematic indices offer a choice of instructional approach. Apart from typical images, the information presented includes patient history, clinical findings, imaging findings as described by a board-qualified radiologist, diagnosis, differential diagnosis and internet links. Elements of the radiologist's report are linked with the images in such a way that the structure or finding described can be interactively highlighted. An evaluation index allows proficiency testing in self study and as a part of taught courses. CONCLUSION: HNORAD is a valuable resource for students, ENT surgeons and radiologists at the undergraduate, postgraduate and CME level for self study as well as for course work.

Computer-Assisted Instruction↗
PubMed2005

[Development of an active robot system for multi-modal paranasal sinus surgery].

BACKGROUND: Severe complications in endoscopic paranasal sinus surgery are rare, however, when they occur they are often fatal. Injuries to the optic nerve or the internal carotid artery mostly occur after penetration of the sphenoid sinus' anterior wall. METHODS: We present the robot system "A 73" with its newly designed 4-canal-microendoscope and special instruments that meets the demands of endoscopic paranasal sinus surgery. A fully automated perforation of the sphenoid sinus' anterior wall was performed in five cadaveric specimens. RESULTS: The sphenoid sinus' anterior wall could be perforated without damaging the surrounding structures in all cases. Subsequently, the approach was enlarged to the desired diameter using telemanipulation mode. The analysis of both the transformation error and intraopertive accuracy showed values in the submillimeter range. CONCLUSIONS: Using a newly developed robotic system, a fully automated perforation of the sphenoid sinus' anterior wall was performed precisely and reproducibly. This approach can be enlarged in a telemanipulation mode.

Cadaver↗
PubMed2004

[Binaural auditory deficit during pregnancy].

Neurological impairment during pregnancy is also commonly found in otorhinolaryngology. Cranial nerve palsy, e.g. of the facial nerve or changes in signal processing of the hearing system, are described. Apart from changes in electrolyte balance, these neurological alterations are attributed to hormone fluctuations. The spontaneous remission of the neurological problems after delivery is frequently reported. This case report presents a 34 year pregnant patient suffering from binaural sensorineural hearing loss and tinnitus in the third trimester. Three weeks after delivery there was a spontaneous remission and a measurable improvement of the audiological findings. Although treatment with cortisone and antibiotics remained without effect, a pharmacological treatment during pregnancy has to be carefully and individually coordinated. An interdisciplinary approach in diagnostic and therapeutic measures together with gynaecologists appears obligatory.

Adult↗
PubMed2004

[Complications with inflammatory diseases of the nasal sinuses].

The close localization of the paranasal sinuses both to the brain and the orbit can even today lead to severe and potentially lethal complications in patients with sinusitis. These incidents are rare, however, they should be duly diagnosed and treated since fatal outcome is described in 5-10% of cases. Current diagnosis and therapy for acute inflammatory complications and mucoceles of paranasal sinuses are presented in this article.

Eye Infections↗
PubMed2004

Sialoscopy--initial experiences with a new endoscope.

BACKGROUND: After the introduction of mini-endoscopes for the diagnosis of swelling of the major salivary glands there has been further development of materials and techniques. A new highly flexible semirigid sialoendoscope with high quality imaging (6000 pixels), an outside diameter of 1.1 mm, a working channel of 0.4 mm, and a separate channel for irrigation has been developed and we examined its clinical value. METHODS: We used the endoscope in 22 patients for diagnosis and treatment. RESULTS: Sialoendoscopy was achieved after dilatation of the papilla in all cases. The image (both in contrast and resolution) was excellent. We found sialolithiasis in 13, stenosis in 3, and sialodochitis in 3. Through the working channel we were able to insert instruments with success in seven cases with pathological findings. One patient developed a complication.

Adult↗
PubMed2004

The concept of a clinical round as a virtual, interactive web-based, e-learning model for interdisciplinary teaching.

The demonstration of patient case reports in the course of a clinical round is an essential part of teaching medicine and dentistry. However, suitable live patients with particular problems are not always available at a time when teaching is taking place. This project therefore had the objective of establishing a web-based, virtual e-learning concept for demonstrating case reports independent of time and place, with the possibility of an interactive examination, diagnosis, and interdisciplinary therapy decision making for medical and dental students. Anonymized case reports of diseases in the oral and maxillofacial region and the interdisciplinary treatment were digitized and prepared in a web-based format. The technical aspect was based on connecting flash modules with videos and animation, and monitoring through HTML and Javascript. Due to the modular concept and the programming used, the learning environment was independent of platform and open. Independent formats (.swf, .avi, .mpeg, etc.) were integrated into the individual modules. According to a hierarchic decision system, the user was guided interactively to the diagnosis through a differential diagnostic exclusion process. Sound was digitized and integrated in mp3 compressed form in the 3D models for lip-synchronous speech output. The speech output was connected with a virtual 3D tutor that acted in an advisory capacity in reaching a diagnosis and determining therapy. Further sources of information and literature with abstracts or pdf files of the subject-related publications were inserted to ensure that the teaching was objective. To conclude the virtual clinical round, a check on learning success was conducted in the form of a multimedia multiple choice test.

Computer-Assisted Instruction↗
PubMed2003

[Surgical therapy of Madelung's disease in the head and neck area].

PATIENTS AND METHODS: Between 1995 and 2001 we treated 12 patients with benign symmetric lipomatosis in the head and neck. The group comprised 11 men and 1 woman aged 34-62 (M=47). The most frequent complaints were diminished range of motion of the head and obstruction when eating or speaking. Combined lipectomy and liposuction were performed in all patients, with liposuction being carried out in a second session. RESULTS: The mean follow-up period was 3 years. The functional results were very satisfactory in all patients. Of the 12 patients, 9 were also satisfied with the aesthetic outcome.A recurrence occurred in three patients 1.5, 2, or 3 years after the operation. Severe complications were not observed. CONCLUSIONS: According to our experience, combined lipectomy and liposuction represents a successful procedure in treating benign symmetric lipomatosis in the head and neck region.Nevertheless, advantages and drawbacks of the two techniques should be equally considered prior to surgery.

Adult↗
PubMed2003

Differential distribution and expression of leptin and the functional leptin receptor in major salivary glands of humans.

Leptin plays a central role in the regulation of food intake and energy expenditure in rodents. However, it has become clear that this hormone has more than only a satiety-inducing function, and that there are other sources of leptin, such as the central nervous system, placenta and the gastrointestinal tract in addition to adipose tIssue. Knowing about the important role of the salivary glands in food intake and digestion, it was the objective of the present study to investigate how leptin and its receptor are expressed and distributed in the major salivary glands of humans. We found leptin distributed throughout the major salivary glands with obvious intracellular concentrations in granula. In contrast, immunostaining for the leptin receptor was found exclusively in the membranes of the glandular cells. A high density of the leptin receptor was localised in the epithelia of the duct lumen. PCR analysis proved the autonomous expression of leptin by the salivary glands independently from adipocytes. Accordingly the long receptor isoform was expressed by any examined tIssue. In the light of recent findings of leptin influencing the growth of rodent salivary glands, the presence and distribution of leptin and its receptor suggests an autocrine role of salivary leptin within the glands.

Autocrine Communication↗
PubMed2001

Transoral removal of submandibular stones.

OBJECTIVE: To assess transoral treatment of submandibular lithiasis. DESIGN: Study of a series of patients with submandibular stones undergoing transoral removal of the sialoliths. Duration of follow-up: 6 months to 7 years. SETTING: Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany, center for treatment of salivary stones. PATIENTS: Two hundred thirty-one patients (127 females, 104 males) suffering from submandibular lithiasis had a mean age of 41.7 years (age range, 12-86 years). Stone location was distal to the edge of the mylohyoid muscle in 115 patients and proximal to the gland in 102 patients (mean size of sialoliths, 6.3 mm [range, 2-30 mm]). Fourteen other patients had 2 separate stones, one within the hilum and a smaller more proximal one within the gland. INTERVENTIONS: Transoral removal of the stones under local anesthesia and preservation of the submandibular gland. MAIN OUTCOME MEASURES: Complete removal of the stones, complications, and recurrence of the stones. RESULTS: All 115 patients with distal stone location, 93 (91%) of 102 patients with stones of the perihilar region, and 9 (64%) of the 14 patients with 2 separate stones in the hilum and parenchyma were free of stones. Submandibulectomy had to be carried out in 4 patients (1.7%). Recurrence of lithiasis and damage to the lingual nerve remained below 1%. CONCLUSIONS: Transoral removal should be the treatment of choice in patients with submandibular stones that can be palpated bimanually and localized by ultrasound within the perihilar region of the gland.

Adolescent↗
PubMed2001

[Results of an in vitro study and initial clinical application of a combined Ho:YAG-/Nd:YAG laser].

BACKGROUND AND OBJECTIVE: A combined Ho:YAG/Nd:YAG laser produces light with properties similar to the beams of the mainly coagulating Nd:YAG laser and the cutting CO2 laser alone. PATIENTS/METHODS: The combined laser was tested in vitro on pig tissue. Additionally, we used this new combined tool for enoral operations. RESULTS: An effect of the pulsed Ho:YAG laser was explosive-like tissue disruption and sprinkling of fragments. Simultaneous use of the Nd:YAG laser resulted in an enlarged zone of coagulation. Clinically, the laser-assisted intervention was inferior to the classic operational methods. CONCLUSIONS: Comparing the established CO2 laser and the Ho:YAG laser, the latter showed only the advantage of delivery via a flexible fiber. Sprinkling of tissue fragments and wide incisions are oncologically problematic. We conclude that this new tool is of minor value for otorhinolaryngologists and head and neck surgeons.

Animals↗
PubMed2001

Localized lymphadenopathy due to leishmanial infection.

A 25-year-old female patient presented with an isolated cervical lymph node enlargement several months after having returned from Spain and Latin America. She had no other signs or symptoms of disease. Leishmania infantum/chagasi was identified as the causative agent. With extended travel activities localized lymph node enlargement due to leishmanial infection should be included in the differential diagnosis of lymphadenopathy of unknown origin.

Adult↗
PubMed2001

A new device for frontal sinus endoscopy: first clinical report.

OBJECTIVE: Endoscopically or microscopically controlled paranasal sinus surgery currently represents the state of the art. For anatomic reasons the ostium of the frontal sinus and the frontal sinus itself are difficult to observe. Flexible endoscopes are often difficult to implement and do not provide enough light intensity to visualize all parts of the frontal sinus. MATERIALS AND METHODS: A specially curved rigid endoscope with a working channel of 1.5 mm that allows passage into the frontal sinus has been developed to manage this problem. The system was used on 15 patients during paranasal sinus surgery to evaluate possible indications and its clinical usefulness. RESULTS: The endoscope could be introduced into the frontal sinus after an ethmoidectomy had been performed in all of the patients. The anatomy of the sinus could be visualized with sufficient light intensity in 14 patients. The shadowing of the frontal sinus seen in CT was not due to polyps of the mucosa of the frontal sinus in all cases, but rather due to secretion with otherwise normal mucosa. In the cases with polyps, it was necessary to irrigate with saline solution to prevent the buoyant polyps from collapsing over the endoscope. The following specific indications for this endoscopic version were established during this first test: intraoperative and postoperative control of the frontal sinus, clinical evaluation of tumor growth into the frontal sinus, biopsies within the frontal sinus, and evaluation of fractures. CONCLUSION: The new device provides further insight within the field.

Adult↗